Topic Contents

Dilated Cardiomyopathy

Topic Overview

What is dilated cardiomyopathy?

Dilated cardiomyopathy is a serious condition that weakens your heart muscle and
causes it to stretch, or dilate. When your heart muscle is weak, it can't pump
out blood as well as it should, so more blood stays in your heart after each
heartbeat. As more blood fills and stays in the heart, the heart muscle
stretches even more and gets even weaker.

Most of the time, this
leads to
heart failure. Heart failure does not mean that your
heart stops pumping. It means that your heart can't pump enough blood to meet
your body's needs.

What causes dilated cardiomyopathy?

The most
common type of dilated cardiomyopathy develops after a heart attack has damaged
the heart muscle. But it can also be caused by many diseases or problems that
may or may not be related to your heart. Sometimes the cause is not known.

Myocarditis,
which is inflammation of the heart muscle. It is caused by a virus or an immune
system problem.

Drinking too much alcohol, using certain illegal drugs such as
cocaine, or taking certain medicines such as
chemotherapy.

Being exposed to toxic
metals, such as lead or mercury.

Being pregnant. In rare cases,
dilated cardiomyopathy develops toward the end of pregnancy or during the first
6 months after a woman gives birth. Experts don't know why this happens.

What are the symptoms?

You may not have any
symptoms at first. Or you may have mild symptoms, such as feeling very tired or
weak.

If your heart gets weaker, you will develop heart failure.
When this happens, you will feel other symptoms, including:

Shortness of breath, especially with
activity.

Tiredness.

Trouble breathing when you lie
down.

Swelling in your legs.

You may get these symptoms slowly, over months or years.
Or you may get them suddenly, such as after pregnancy or an illness caused by a
virus.

Heart failure that suddenly gets worse is an emergency. Get
medical help right away if:

You have severe trouble breathing.

You cough up pink, foamy mucus.

You have a new irregular or rapid heartbeat.

When you have heart failure, keeping track of your symptoms every
day is important. Call your doctor if:

You have a sudden weight gain such as
3 lb (1.4 kg) or more in 2 to 3
days.

Your ability to exercise changes.

You have
any change in your symptoms.

How is dilated cardiomyopathy diagnosed?

Your
doctor will ask questions about your symptoms and past health. He or she will
want to know about recent illnesses and about heart disease in your family.
Your doctor will listen to your heart and lungs and check your legs for fluid
buildup.

How is it treated?

You will probably need to take several medicines to treat heart failure caused by dilated cardiomyopathy. It is very important to take your medicines exactly as your doctor tells you to and to keep taking them. If you don't, your heart failure could get worse.

Your doctor may suggest a mechanical device to help your
heart pump blood or to prevent life-threatening irregular heart rhythms. Such
devices include a
pacemaker for heart failure (also called cardiac resynchronization therapy or CRT), an
implantable cardioverter-defibrillator (ICD), or a
combination pacemaker and ICD. If your condition is very bad, a heart
transplant may be an option.

Self-care is an important part of your treatment. Self-care includes the things you can do every day to feel better, stay healthy, and avoid the hospital.

Take your medicines as prescribed. This gives you the best chance of being helped by them. Some medicines for heart failure include:

Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). These make it easier for blood to flow.

Diuretics. These help remove excess fluid from the body.

Beta-blockers. These slow the heart rate and can help the heart fill with blood more completely.

Live a healthy lifestyle. It can help slow down heart failure. Limit salt, try to get regular exercise, and don't smoke.

Watch for signs you're getting worse. Weighing yourself every day to watch for sudden weight gain is a good way to do this.

Find out what your triggers are, and learn to avoid them. Triggers are things that make your heart failure worse, often suddenly. A trigger may be eating too much salt, missing a dose of your medicine, or exercising too hard.

What can you expect with dilated cardiomyopathy?

Most of the time, dilated cardiomyopathy leads to heart failure. Heart
failure usually gets worse over time, but treatment can slow the disease and
help you feel better and live longer. In more and more cases, the problem is
being found earlier, when it can be better managed.

Sudden cardiac death, which means the heart suddenly stops
working. This may be more likely to happen to people who have serious rhythm
problems (arrhythmias) in one of the lower heart chambers (ventricles).

If a woman gets dilated cardiomyopathy from pregnancy,
she should not get pregnant again. This is true even if her heart problem gets better.

If your disease is getting worse, you may
want to think about making end-of-life decisions. It can be comforting to know
that you will get the type of care you want.

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

Decision Points focus on key medical care decisions that are important to many health problems.

Other Places To Get Help

Organizations

American Heart Association (AHA)

7272 Greenville Avenue

Dallas, TX 75231

Phone:

1-800-AHA-USA1 (1-800-242-8721)

Web Address:

www.heart.org

Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.

Heart Rhythm Society

1400 K Street NW

Suite 500

Washington, DC 20005

Phone:

(202) 464-3400

Fax:

(202) 464-3401

Web Address:

www.hrsonline.org

The Heart Rhythm Society provides information for
patients and the public about heart rhythm problems. The website includes a
section that focuses on patient information. This information includes causes,
prevention, tests, treatment, and patient stories about heart rhythm problems.
You can use the Find a Specialist section of the website to search for a heart
rhythm specialist practicing in your area.

National Heart, Lung, and Blood Institute
(NHLBI)

P.O. Box 30105

Bethesda, MD 20824-0105

Phone:

(301) 592-8573

Fax:

(240) 629-3246

TDD:

(240) 629-3255

Email:

nhlbiinfo@nhlbi.nih.gov

Web Address:

www.nhlbi.nih.gov

The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating:

Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.

National Institutes of Health Senior
Health

9000 Rockville Pike

Bethesda, MD 20892

Phone:

1-800-222-2225 Aging Information Center

TDD:

1-800-222-4225

Email:

custserv@nlm.nih.gov

Web Address:

www.nihseniorhealth.gov

This website for older adults offers aging-related
health information. The website's senior-friendly features include large
print, simple navigation, and short, easy-to-read segments of information. A
visitor to this website can click special buttons to hear the text aloud, make
the text larger, or turn on higher contrast for easier viewing.

The
site was developed by the National Institute on Aging and the National
Library of Medicine, both part of the National Institutes of Health
(NIH). NIHSeniorHealth features up-to-date health information from NIH. Also,
the American Geriatrics Society provides independent review of some of the
material found on this website.

Hunt SA, et al. (2009). 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 119(14): e391–e479.

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